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Harmonic Imaging Improves Sensitivity at the Expense of Specificity in the Detection of Patent Foramen Ovale
Author(s) -
Madala Durga,
Zaroff Jonathan G.,
Hourigan Lisa,
Foster Elyse
Publication year - 2004
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/j.0742-2822.2004.02168.x
Subject(s) - patent foramen ovale , medicine , shunt (medical) , false positive paradox , cardiology , second harmonic imaging microscopy , contrast (vision) , radiology , laser , physics , percutaneous , machine learning , artificial intelligence , computer science , optics , second harmonic generation
Contrast echocardiography using agitated saline is widely employed to detect right to left shunt in patients with suspected patent foramen ovale (PFO). The sensitivity of fundamental transthoracic echocardiography (FTTE) is often limited by poor far‐field resolution. The purpose of this study was to evaluate the test characteristics of harmonic imaging during transthoracic echocardiography (HTTE) for the detection of PFO. Methods: Sixty‐four patients referred for transesophageal echo (TEE) for clinical indications underwent FTTE and HTTE during saline contrast injections. Results: TEE identified nine PFOs. For FTTE, the sensitivity was 78% and the specificity was 100%. For HTTE, the sensitivity was 100% and the specificity was 82%. All ten false positives with HTTE occurred after five cardiac cycles, suggesting transpulmonary transit of the bubbles. Conclusion: In the detection of PFO, HTTE improves sensitivity at the expense of specificity, particularly if the timing of contrast appearance in the left heart is ignored. (ECHOCARDIOGRAPHY, Volume 21, January 2004)